Re: Patients who smell of alcohol

[Guest guest]

What about the patient who smells of tobacco? We know that the nicotine from

tobacco can delay/slow healing. Do you send the tobacco user away? What about

the person who smells of marijuana? Marijuana ingestion can impair pain

perception. Do we send that patient home?

I think the important question is not if the person smells of a particular

substance, but rather if the substance the person smells of negatively impacts

treatment. If the substance does negatively impact my treatment then I can, 1,

Change my treatment, 2, Confirm that the substance is in fact what I smell, 3,

Have the patient change/stop the substance use, 4, Decline to treat the patient,

or 5, Accept the reduced results and do nothing (not the best option).

While I can personally disdain working with people who smell of various

substances, such as perfumes, body odor, bad breath, alcohol, tobacco,

marijuana, etc, I need to make sure that I maintain my professional ethics and

responsibilities.

Hansen, PT, PhD

Physical Therapist

Rehabilitation Institute of Kansas City

Kansas City, Missouri

>

> Hi Mike and ,

> Thanks for your responses. I didn’t think about medications that could

create that smell. Interesting. I guess the other issue I always think about

is you really don’t know how much alcohol they have had so behavior is

certainly your best tool for decision making. We have offered a cab on

occasion. A clinic policy is a good idea.

> Lori

>

> From: PTManager [mailto:PTManager ] On Behalf

Of M. Howell PT, MPT

> Sent: Thursday, March 17, 2011 11:45 AM

> To: PTManager

> Subject: RE: Patients who smell of alcohol

>

>

>

> Hi Lori,

>

> Good responses so far which I agree with. I only wanted to add that make sure

you have a policy to handle the behavioral issues. Should this person decide to

take legal action against you, it helps to show a policy and training of staff

and that you were just following your clinic policy. All clinics should have a

policy about requesting a patient, staff or visitor to leave the premises and

under what conditions. It would be common sense as has been suggested to offer

calling a cab and even call the cab company so there is a record that you did.

Once outside the clinic, the person bears the responsibility for themselves.

>

> M. Howell, P.T., M.P.T.

>

> Howell Physical Therapy

>

> Eagle, Idaho

>

> <mailto:thowell@...<mailto:thowell%40fiberpipe.net>>

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> From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf

Of Mike Hampton

> Sent: Thursday, March 17, 2011 9:42 AM

> To: PTManager <mailto:PTManager%40yahoogroups.com>

> Subject: Re: Patients who smell of alcohol

>

> Hi Lori,

> We have discussed this within our departments as well and I have sought

> guidance from our risk management folks. We focus on behavior. The issue with

> the " smell " of alcohol is that there are medications that have a side effect

of

> an alcohol type smell on the breath. Therefore, you can't assume that just

> because one smells of alcohol, they were drinking. If instead you focus

> on behavior and the patient is acting odd, showing signs of inebriation,

> disruptive etc., then there is cause ask the patient to leave. You have to

then

> also consider allowing the patient to drive if they are showing obvious signs

of

> impairment. We are fortunate to have security here that can intervene and

> suggest the patient take a cab etc.

>

> Mike Hampton PT, MPT

> Outpatient Therapy Manager

> PeaceHealth St. ph Medical Center

> Bellingham, WA

>

>

>

> ________________________________

> From: " Libolt, Lori F. " <lflibolt@...<mailto:lflibolt%40hinet.org>

<mailto:lflibolt%40hinet.org> >

> To: " PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com> "

<PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com> >

> Sent: Wed, March 16, 2011 5:39:31 PM

> Subject: Patients who smell of alcohol

>

> Hello everyone,

> So I know we have all encountered the patient who arrives at 8:00, completely

> put together, yet smells of alcohol. With this repeated occurance I was

curious

> how people deal with this. Do you ignore it? Say something to the patient?

etc..

>

> Lori Libolt, OTR/L,CHT

> ReBound OT, PT, Hand Therapies

> (Bellingham)

> (Lynden)

> (fax)

> lflibolt@...<mailto:lflibolt%40hinet.org> <mailto:lflibolt%40hinet.org>

<mailto:lflibolt@...<mailto:lflibolt%40hinet.org> <mailto:lflibolt%40hinet.org>

>

>

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